The killer and me

By Jonathan Stanley

Op-ed New York Post Monday, August 4, 2003

From just inside the church door, the rifleman fired at strangers. One shot killed Eileen Tosner, a mother of five. Another fatally struck Fr. Lawrence Penzes at the alter. More would have been hit but for an ex-Marine’s tackle.

By adopting new laws and using the ones it has, New York could have stopped those tragedies. I know: It could have been me in the back of that church. Peter Troy, sentenced for those Long Island murders last week, and I each have a severe mental illness. My untreated symptoms are not as consistently debilitating as Troy’s schizophrenia, but my bipolar illness is the type with “psychotic features.”

At the worst, I perched on a milk crate in the middle of a Manhattan deli, naked. Secret agents had followed me for three sleepless days and nights. They sought to capture me and study my powers – mind reading, telepathic control of animals, a mind-generated electronic beam. These had kept me free, but now I was cornered.

Fighting fire with fire, the agents directed radiation intothe deli from a satellite dish. The floor seethed deadly. Only the crate insulated me.Stepping down brought pain, real and agonizing pain.

Imprisoned on a milk crate, my running was over. I hadn’thurt anyone, but – with a slight shift in my delusion-controlled world – I would have.

Troy, 34 at the time of the shootings, had been on and offmedications since his illness struck at age 21; it is the difference between him and me.With proper care, the symptoms of severe mental illnesses can be tamed, at least renderedmanageable. Without it, they can overwhelm – sometimes so intensely that the afflictedharm themselves or others.

I didn’t believe I was sick. Neither did nor does PeterTroy. This is no doubt the result of anosognosia, a physiological effect of severepsychiatric disorders that renders people incapable of assessing their condition.

Laws, mechanisms and resources must be available tointervene when such symptoms run unchecked. What of these there are failed Peter Troy, andalmost did me.

Eleven months before he entered that church, a doctor atBellevue Hospital determined and reported that Troy needed court-ordered and -supervisedoutpatient treatment pursuant to Kendra’s Law, which permits involuntary treatment if arelapse is likely to bring harm to the patient or another person. But Troy had alreadyleft Bellevue and wasn’t found. The haphazard investigation was wait-listed, then closed.

Kendra’s Law has worked spectacularly – the state Office ofMental Health reported this year on those placed under an initial six-month court-orderunder the law: 77 percent fewer were hospitalized in the half-year after the treatmentmandate than were in the six months before it. And 85 percent fewer experiencedhomelessness, 83 percent fewer were arrested and 85 percent fewer were incarcerated.

But an unused law can’t prevent catastrophe.

Troy was hospitalized again because of erratic behavior.This time, New York’s inpatient-commitment law kept him from care: A judge denied aphysician’s application for continued hospitalization, for a person can only be held in ahospital if found to be a danger to himself or others.

That same standard threatened me. After being brought infrom that deli, I was almost released from a psychiatric facility after the 72-hourobservation period: I was deemed psychotic, but my flight from imagined adversaries wastaken as proof both of my desire for self-preservation and lack of animus to others – Iwas no danger. But my father somehow got me to sign a voluntary admission form, saving mefrom another frenzied sally on the city’s streets.

In authorizing hospitalization, other states look at theneed for treatment, probability of deterioration, inability to function independently andincapability of making informed decisions. But New York law still refuses aid to thoserendered irrational by psychosis in apparently nonthreatening ways. If New York won’ttreat people in such conditions until they become dangerous, it will get dangerous people.

I am exceedingly peaceful. Wednesday, Peter Troy wassentenced to prison for two consecutive life-terms for two murders. Yet when I look athim, I look at myself. I feel my fortune and his fate. And I wonder what will happen tothe next ones like us.

When they lose their minds to these treatable illnesses,will their care be more than happenstance?

Jonathan Stanley has been a practicing attorney and is(former-ed) assistant director of the Treatment Advocacy Center Ca nationalnonprofit dedicated to removing barriers to treatment for people with severe mentalillnesses.